My Life Mission

Once again I personally want to thank all of you in my friend and family circle and among my patient population, who support my mission work.  I am committed to helping those who cannot get the plastic surgery that they desperately need throughout the world.
As most of you know, I have been lucky enough to befriend some of the world's best plastic surgeons and humanitarians to help me achieve this goal.  I never want to pretend that I do this work alone.

Please take a second and check out the video of my most recent mission to Bilaspur, India.  If you are interested to donate and contribute to future missions, please inform my office and they will guide you.

The Human Mission

I started seeing patients the moment we arrived at Apollo Hospital in the small rural town of Bilaspur. There was no time to rest. These patients had been waiting for us for weeks to arrive. It was during this clinic time, on this day, that I realized something that really struck me to the core. I have been to India to do these missions many times. Heck, I have been to the Philippines and other countries, but this was different somehow. Mostly on these missions, I was treating congenital deformities. These are deformities that patients have no control over. This is how they were born. I can deal with congenital deformities. This is what I was trained for, but what I was seeing today was horrific, sad and unimaginable to my Westernized mind. This was the fourth medical mission for the American Society of Indian Plastic Surgeons (ASIPS). I rounded up some of the best plastic surgeons, an all-star cast, from the US for this mission. Dr. Munish Batra (San Diego), Dr. Shashi Kusuma (Ft Lauderdale), Dr. Vineet Mehan (Fairfax), Dr. Satish Vyas (Detroit). Good fortune was smiling on me when my dearest friend Dr. Chanjiv Singh, an amazing plastic surgeon from India agreed to come along and even help set up this mission. We were a team of six dedicated plastic surgeons, dedicated to our craft, dedicated to humanity. Escorted up to the clinic area, I could see the patients lined up waiting for my arrival. Hundreds of people with all sorts of deformities anxiously awaiting my arrival. Just walking to the designated office became an ordeal as the patients wanted me to see them right in the hallway. « Doctor..doctor », they screamed wanting to be heard and seen right there in the hallway. I motioned for them to wait and assured them that we would see all of them, not knowing if I had just made them an empty promise. How could we see all these patients in one day. There were too many. Sitting in an office surrounded by local doctors, nurses and even hospital administrators, who were there to help me translate and communicate with the patients. My Indian heritage is obvious when you see my brown skin, but having spent most of my life in the US, it is just as obvious that I am a foreigner in my own land. I know how to speak Hindi, the main language of India, but I also know my limits. The first patient came in with severe burn contractures to her face and torso. She was an untouchable to the locals, who was about to touch me deep in my own humanity. The local staff practically ordering this woman to sit. Her eyes filled with fear and apprehension. A frozen scarred face. A mind probably filled with complex emotions that I would not even begin to comprehend. To her, I was a strange doctor from a far away land that she could not even imagine. To me, she was a patient that I came to help. Pulling my chair right up to this woman’s side, I wanted to stay eye level with her during my examination. I wanted her to feel comfortable with me. I wanted her to maintain her dignity, if there was any left. I wanted to show her the respect she so deserves and has earned. As she recounts her story, I realized how much pain this woman has endured and will continue to endure. First the fake version of the story, this was an accidental burn. Then the truth, a deliberate act by a cowardly man to disfigure a beautiful woman, a wife for reasons that make no sense to this Westernized brown doctor. Sadly enough, I have treated many burns in my life as a plastic surgeon, but this was different. This is a site that most human beings should never have to see, let alone endure. It is devastating to see a once beautiful woman turn into something so horrific. Her neck skin is fused to her chest and breast. Her lower lip is adhered by scar tissue to her chin, which now is a confluence of hard scar that is also adhered to her chest. Where once there were breasts are now nothing but hard thickened scar that have no semblance of anything human. Her womanhood stripped from her in a violent act of cowardice by her husband. I gently put my arms around this woman and assured her that we were going to help her to the best of our capability. Her inferiority complex was palpable. She was an untouchable thrown out of her own world and rejected to fend for herself. This woman was probably clinging to whatever humanity and dignity that still remains in her. Painful and extremely disfuguring scars are all this woman knows and will ever know. My heart was bleeding for this woman. I am her doctor but I am also a fellow human being, who can see right through her suffering eyes. This was the moment that struck me. This was not a congenital deformity I was treating, this was a preventable crime committed by the one person she probably trusted the most, her husband. This woman was a hero to me just because she was alive. I wanted to reach out and touch her heart with my hands, instead all I could offer her was my scalpel and a promise to restore her to some semblance of normal. If I could cut out her pain with my knife blade, I would have offered her that. With my knife blade, I would try to restore her dignity, restore her womanhood, restore her humanity. This untouchable woman touched me in ways too profound even for me to comprehend. As I booked her surgery, I motioned the staff to bring in the next patient. I suddenly realized, this was only my first patient. This was going to be a long day. The American Society of Indian Plastic Surgeons (ASIPS) has dedicated its existence to providing access to plastic surgery to those extremely underserved in rural India.

How do you choose a size for breast augmentation?

This is perhaps the most fun part of the procedure. The goal of the augmentation is to restore volume and projection to the breast. During a consultation, patients can "try on" different sized implants to see which size gives the most natural appearance. Being attentive to a patient's wishes and desires is extremely crucial in finalizing the correct size.

The patient's height and body shape, along with the pre-surgical dimensions of her breast plays a prominent role in determining the size to acheive a natural look. The pre- operative tissue stretch and existing volume will determine the size of the implant that is chosen. Implants come in various dimensions and profiles and implants that are too large can often distort the anatomy. The surgeon will guide you in making the best choice to suite your individual goals.

Most of my patients want a natural look that fits their body. This is desirable in my opinion. Often when we hear that there is a problem, it is usually related to the implant being too large for a patient's frame. The other issue is that the implant should not be too small either. I usually give patients a range of sizes and often pick the size that best fits their body.

Q/A: How does smoking affect plastic surgery? Can I still have plastic surgery if I smoke?

Everyone knows the ill-effects of smoking. Media coverage is abundant when it comes to the detrimental effects of smoking. We know that it causes all sorts of cancers, but lets explore how smoking affects plastic surgery.
Smoking affects the microcirculation in the body. It causes the smallest blood vessels to constrict even more. This prevents blood from flowing into areas that are important during healing process. After plastic surgical procedures, whether big or small, we are relying on your ability to heal wounds. Smoking affects this process.
Another affect of smoking occurs with each puff of the cigarette. With each puff, instead of oxygen, carbon monoxide is delivered into the lungs. This same carbon monoxide is then delivered to a wound during the healing process. Now the wound, which needs oxygen to heal, is getting poisoned by the carbon monoxide.
The combination of constricting blood vessels and the absence of oxygen being delivered to a wound adversely affects wound healing. Most of the procedures that are performed in plastic surgery rely on wound healing to occur correctly and effectively. Smoking adversely affects how a wound heals.
The general recommendation of American Society of Plastic Surgery is for patients to quit smoking about 2 weeks prior to the procedure and to remain smoke free at least 4 weeks post surgery.

What factors make skin age faster? Is there something I can do to prevent this?

Anti-aging medicine is a catch term that has become very popular in the last decade. The skin is the first manifestation of the aging process. There are a number of factors that have been shown to speed up aging of the skin. Fortunately, these are factors that are within your control. Any steps that you take to adjust these factors will help to slow down aging of the skin. Remember these seven factors and make adjustments in your life as needed!

1. Sun Exposure
2. Smoking
3. Dry Extreme Cold Weather
4. Lack of a Sleep
5. Stress
6. Lack of Exercise
7. Too much Alcohol

Are there any non-surgical solutions for excessive underarm sweating and palmer sweating?

Hyperhidrosis (excessive palmer and underarm sweating) is a real problem faced by many patients in the United States. It affects patients both on a personal social level and even professional level. This can have a profound effect on productivity at work.

Although, there are many solutions to this problem, Botox injections are very effective in helping control the hyperhidrosis. Botox works to block the neurotransmitter that results in the excessive sweating. It is injected directly into the affected area. This can be done in the office setting under local anesthesia. There is little to no downtime. It takes a few days for the Botox to start working. Once it takes effect, it will temporarily stop the excessive sweating.

Cleft Lip and Palate: Plastic Surgical Missions

One of the aspects of our healthcare that does not get noticed is that of the commitment of US surgeons to provide healthcare in many parts of the third world.  There are thousands of MD's in this country who take the time to travel to another country to provide their expertise to those in need.  In particular, plastic surgeons from the US routinely travel to countries like Philippines, Thailand, India, and many African nations to provide cleft lip and palate repair to those patients who do not have access to healthcare.  As most of my patients know, I have been traveling annually with a group of my colleagues to the Philippines to perform cleft lip and palate surgery.

Today, I will be traveling with a different set of colleagues to India to perform reconstructive surgery for people who do not have access to healthcare.  It is a combined effort with the American Society of Indian Plastic Surgeons (ASIPS) and the Indian Society of Plastic Surgeons.  This is an amazing collaboration between two groups of surgeons with a common goal: to help those who are less fortunate.  

These types of activities are certainly not unique as I have pointed out.  However, I wish that more of this type of activity get the publicity that it deserves.  Doctors in this country are the best in the world and this has to be one to the top reasons.